Oh, it is a hideous way to start a Monday morning, I agree. A discussion such as this is best held for later in the week, closer to the weekend but not so close so that it offers anticipated salvation; but still far enough along that burdens abound and life itself almost seems no longer worth living. That would be the optimum time for a dialogue such as this, but alas, I am not known for my coordination of appropriateness. No, I really suck at that.

Sorry.

A California surgeon has been disciplined by medical boards in two states over the alleged mishandling of a rectal procedure in a hospital emergency room. It is apparently frowned upon for a doctor to play Spin the Bottle with an object wedged deep inside someones rectum.

A hat tip to the person who sent me this story. They shall remain anonymous, as they are a highly regarded member of the legal community in workers' comp. I am not identifying this person because they should wish to remain a highly regarded member of the legal community in workers' comp.

On December 4, 2010, a patient was admitted to a California hospital ER , telling medical staff that he had inserted a bottle into his rectum two days earlier. We don't really know why. Perhaps his hands were full and he just had no other way to hold it. He was in pain, (duh) and went two days without a bowel movement. Plus he probably wanted to be able to return the bottle for the 10 cent deposit (it was California after all, and they are nothing if not environmentally sensitive). 

The physician's assistant “documented distention and diffuse tenderness. A plain abdominal X-ray showed a glass bottle in mid-pelvis. There was no free air, although the patient was in the supine position.” That means he was lying on his back. If he had done that all along there probably wouldn't be a bottle wedged in his fanny.

Anyhoo, a surgeon was called, and she ordered 25 mcg of Fentanyl for pain. I have no idea what she ordered for the patient.

Here is where it gets a bit strange. The surgeon explained (at a hearing after a complaint was filed) that she “gave the patient two options. Going to the operating room- or manual extraction in the ER.” The surgeon testified that the patient chose the ER route, “because he did not want to lose his new job.”

I have no idea what his new job was, but I'm guessing it wasn't “Rocket Scientist”. Perhaps this bottle insertion occurred as a workplace accident, and he was in fear of a retaliatory termination for filing a claim. We will sadly never know; mostly because I am too lazy to find out.

The surgeon could apparently feel the bottom of the bottle with one finger, but was unable to extract it. She “was able to palpate the bottle and was able to manipulate the bottle and move the foreign body around but was unable to rectally extract it.” 

That had to be an extraordinarily fun procedure to endure. But it gets better. The surgeon testified she “placed her hand into the rectum to remove the bottle while the patient pushed.”

Owie. 

But she was apparently very determined to get that damn bottle. A nurses notes indicated the surgeon “placed her arm into the rectum up to her bicep and the patient was screaming in pain”.

I'm sure he was. Frankly, I don't even think that is physically possible. If she really had her arm embedded “up to her bicep” in the mans rectum, she not only should have been able to grab the bottle, she could have tickled his tonsils. She could have just pushed the bottle out of his mouth. This same nurse also reported that the surgeon would not give the patient any additional pain medication because she “needed the patient to help push the bottle out.”

Out of his nose, if the nurses notes are to be believed. Judging from those notes, I think we know who was getting the good drugs that day in the ER.

Unfortunately for our human vending machine, new additional X-ray's suggested that a perforation had occurred. Perhaps the surgeon failed to remove her watch or something. He was taken to surgery for a bottleectomy.

It seems our wayward bottle bearer wasn't the only one to end up with a painful rectal exam.

The good doctor was taken before a medical board, and found guilty of a variety of offenses that involve both “gross negligence” and “negligent behavior”. Her license was revoked, but that action was stayed and she was placed on probation for 3 years. As long as she did not embed her entire arm in someones fanny and wave them around like Kermit the Frog during that period she would be in the clear.

Unfortunately for her, the state of Ohio, where she was also licensed, heard about this and decided to have a look into this man's rectum. For reasons not really clear, other than they didn't want this happening in their state, they also initiated an investigation over the incident. She responded 3 days beyond the deadline, and failed to request a hearing, so the Ohio Medical Board revoked her license.

The lesson here, if there is indeed a lesson, is that one best not place foreign objects in their rectum; at least not without a competent insurance plan, and a doctor with freakishly small hands. The other lesson, for medical professionals, is that disciplinary action in one state will trigger action in other states where they are licensed. Be aware of that, if you are a gung-ho personality willing to go “all in”, where no man or woman has gone before.

 

 

 

Leave a Reply

Your email address will not be published.